Web-based Comparative Patient-reported Outcome Feedback to Support Quality Improvement and Comparative Effectiveness...

Area of Science:

• Orthopedic surgery outcomes research
• Health services research
• Quality improvement in healthcare

Background:

• Patient-reported outcomes (PROs) are underutilized in current healthcare quality monitoring and surgeon feedback systems.
• Traditional quality measures often exclude patient perspectives on pain and function after procedures.

Purpose of the Study:

• To design and implement a secure website for returning comparative PRO reports to surgeons.
• To integrate PROs into quality monitoring and comparative feedback for total joint replacement (TJR).
• To facilitate patient-centered quality improvement and outcomes research.

Main Methods:

• Developed a secure website within the Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement (FORCE-TJR) program.
• Designed surgeon-specific comparative PRO reports based on user input for content and data display.
• Structured website data hierarchically for national, practice, and individual surgeon levels, offering downloadable reports.

Main Results:

• Launched the reporting website in September 2012, with quarterly updates.
• As of September 2014, over 22,000 patients and 130 surgeons across 22 states were enrolled.
• Surgeons receive quarterly comparative data on site- and individual-specific outcomes against national benchmarks.

Conclusions:

• This novel system provides quarterly surgeon feedback incorporating PROs for pain relief and functional gain, extending beyond complication rates.
• The enhanced data is expected to drive patient-centered quality improvement and outcomes research.
• Comparative PRO data will become increasingly crucial for surgeons to self-monitor practice outcomes as insurers consider their implementation.